ASSESSMENT OF THE UTILITY OF REPEAT FIBEROPTIC BRONCHOSCOPY IN DIAGNOSIS

评估重复纤维支气管镜检查在诊断中的效用

• 批准号: 2571308
• 负责人: F P OGNIBENE
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/2571308
• 关键词: HIV infections; blood disorder diagnosis; bronchoscopy; clinical research; diagnosis design /evaluation; diagnosis quality /standard; fiber optics; human subject; immunopathology diagnosis; neoplasm /cancer diagnosis; relapse /recurrence; respiratory disorder diagnosis

Recurrent pulmonary symptoms in immunocompromised (IC) patients are a common problem that poses diagnostic and therapeutic challenges. Repeat fiberoptic bronchoscopy (FOB) is often performed because it is relatively safe and more invasive procedures may be contraindicated. This study's purpose was to evaluate the diagnostic and therapeutic efficacies of repeat FOB in IC patients. A retrospective chart review was performed for all IC patients undergoing repeat FOB in our department from January 1, 1987 through June 30, 1992. Patients were classified as having either "persistent" pulmonary disease (as documented by repeat FOB performed within 30 days of initial FOB) or "new" disease (as documented by repeat FOB performed after 30 days from the initial FOB). In patients with HIV infection, a new diagnosis was found in 8 of 25 (32%) repeat FOBs with new disease and 2 of 20 (10%) with persistent disease (P=NS). A change in therapy was initiated in 14 of 25 (56%) repeat FOB with new disease, and 7 of 20 (35%) with persistent disease (P=NS). In hematologic/oncologic disorders, a new diagnosis was found in 10 of 20 (50%) repeat FOBs with new disease and in 12 of 42 (29%) with persistent disease (P=0. 10); a change in therapy was initiated in 14 of 20 (70%) repeat FOBs with new disease and in 24 of 42 (57%) with persistent disease (P=NS). In patients with other immunocompromised conditions, a new diagnosis was found in 3 of 10 (30%) repeat FOB with new disease and 1 of 4 (25%) with persistent disease (P=NS). A change in therapy was initiated in 5 of 10 (50%) repeat FOBs with new disease and in 2 of 4 (50%) with persistent disease. We concluded that the diagnostic yield for repeat FOB in patients with HIV infection was equally effective in the presence of new or persistent disease. In patients with hematologic/oncologic disorders and new disease, repeat FOB may be more likely to establish a new diagnosis (P=0.10).

免疫功能低下（IC）患者的复发性肺部症状是 这是一个常见的问题，给诊断和治疗带来了挑战。 经常进行重复纤维支气管镜检查（FOB），因为它 相对安全，侵入性更强的手术可能 禁忌。这项研究的目的是评估诊断 以及反复FOB治疗IC患者的疗效。 对所有IC患者进行回顾性病历审查 从1987年1月1日到2008年1月1日， 1992年6月30日患者被分为以下两类： “持续性”肺部疾病（根据重复FOB记录 在初始FOB的30天内进行）或“新”疾病（如 通过在初始日期30天后进行的重复FOB记录 FOB）。在艾滋病毒感染患者中， 8/25（32%）例新发疾病重复FOB，2/20（10%）例新发疾病 持续性疾病（P=NS）。14例患者开始改变治疗方法 25例（56%）因新发疾病重复FOB，7例（35%） 持续性疾病（P=NS）。在血液学/肿瘤学疾病中， 在20例新发疾病的重复FOB中，10例（50%）发现了诊断 42例持续性疾病中有12例（29%）（P=0. 001）。10）; a change in 在20例新发疾病的重复FOB中，14例（70%）开始治疗 42例持续性疾病中24例（57%）（P=NS）。患者 与其他免疫功能低下的条件下，一个新的诊断发现， 在10例新发疾病重复FOB中有3例（30%）， 持续性疾病（P=NS）。5例患者开始改变治疗方法， 10例（50%）新发疾病重复FOB，2/4例（50%） 持续性疾病。我们的结论是， HIV感染者重复FOB同样有效， 新的或持续性疾病的存在。患者 血液/肿瘤疾病和新发疾病，重复FOB可能 更有可能建立新的诊断（P=0.10）。